Nonadherence is still a major problem

January 22, 2007

A survey commissioned by pharmacist groups indicates once again that patients are often not adhering to directions for prescription medications.

About one-third (34%) of consumers questioned said they had forgotten to take a prescription medication in the previous six months, and 17% said they had not filled a prescription they were given in the past six months, according to the report released by the National Community Pharmacists Association and Pharmacists for the Protection of Patient Care (P3C) at a press conference in Washington, D.C., last month. The telephone survey, which questioned 1,000 adults over several days in October, was conducted by a group called The Polling Co.

Citing earlier findings that the cost of nonadherence is about $100 billion a year, Bruce Roberts, R.Ph., executive VP/CEO of NCPA, said, "That does not even begin to describe what the real toll is from prescription drugs not being taken properly." The human costs include, he said, increased heart attacks, strokes, amputations, and even death.

Asked whether the survey might overstate the problem, since an individual would have to be superhuman to never miss a dose, Roberts agreed, but he added, "When some statistics show folks staying compliant on a medicine for only-depending on the medicine-60 or 90 days, we have a huge issue here."

In other findings, 29% of those surveyed said they had sometimes stopped taking an Rx before the directions said to do so or before their supply ran out, with 15% saying they'd done that in the past six months. And 38% said they had forgotten to take a drug, with 26% saying they had done so in the past six months.

The top reasons people gave for making changes to the way they were taking prescribed medication were that they felt better or did not need to take the medication or fill the Rx (18%); they wanted to avoid side effects (16%); and they felt the medication was not effective (11%).

Respondents were also asked to rate pharmacists on a one-to-five scale with one being "not at all trustworthy" and five equating to "extremely trustworthy," in terms of "protecting and helping" them with prescription drugs. Eighty-three percent of the respondents rated pharmacists at four or five.

Kellyanne Conway, head of the survey firm, said, "According to the survey results and the focus groups we conducted ... it also seems that the pharmacist has an important role in correcting nonadherent behaviors, because the pharmacist is seen by the broader public as accessible."

However, other responses indicated that R.Ph.s still have to educate the public on how they can help. When asked to describe what a pharmacist does, 76% cited activities related to dispensing medications to patients. Only 19% mentioned advising and consulting with patients. That included 17% who identified pharmacists explaining medication side effects or dosages.

On the other hand, 83% strongly agreed or somewhat agreed that R.Ph.s can help reduce drug-related problems and healthcare costs by helping patients take medications correctly. Also, 86% said they were very likely or somewhat likely to take time to discuss their medications face-to-face with a pharmacist.

THE AUTHOR is a writer based in the Washington, D.C., area.